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Winter Swimming

Body Hardening and Cardiorespiratory Protection Via Sustainable Acclimation

Manolis, Antonis S. MD1; Manolis, Stavros A. MSc2; Manolis, Antonis A. DPT, MS3; Manolis, Theodora A. MD4; Apostolaki, Naomi PhD5; Melita, Helen MD6

doi: 10.1249/JSR.0000000000000653
Competitive Sports/Section Articles

Winter swimming is a stressful condition of whole-body exposure to cold water; however, winter swimmers have achieved variable degrees of adaptation to cold. The question arises whether this extreme sport activity has any health benefits or whether it may confer potentially harmful effects. As a form of aerobic exercise, albeit more strenuous when performed in cold water, winter swimming may increase body tolerance to stressors and achieve body hardening. When practiced by individuals who are in good general health adopting a regular, graded and adaptive mode, winter swimming seems to confer cardiovascular (CV), and other health benefits. On the other hand, unaccustomed individuals are at risk of death either from the initial neurogenic cold-shock response, or from progressive decrease of swimming efficiency or from hypothermia. Furthermore, as it may occur with any intense exercise, individuals with evident or occult underlying CV conditions may be more susceptible to adverse effects with provocation of arrhythmias and CV events that may pose a significant health risk. Hence, a stepwise strategy to initiate and build up this recreational activity is recommended to enhance and sustain acclimation, achieve protection from potential risks of cold-water exposure and possibly avail from its promising health benefits. We need more data from prospective studies to better investigate the short- and long-term health consequences of this important recreational activity.

1Athens University School of Medicine, Athens, GREECE

2National Technical University of Athens, Athens, GREECE

3Patras University School of Medicine, Patras, GREECE

4Red Cross Hospital, Athens, GREECE

5University of Bristol, Bristol, UNITED KINGDOM

6Onassis Cardiac Surgery Center, Athens, GREECE

Address for correspondence: Antonis S. Manolis, MD, Third Department of Cardiology, Athens University School of Medicine, Vas. Sofias 114, Athens 115 27, Greece; E-mail:

Copyright © 2019 by the American College of Sports Medicine.